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Year : 2007  |  Volume : 20  |  Issue : 1  |  Page : 26

The Changing Motivation of Massage Therapy Students

Sutherland – Chan School and Teaching Clinic, Toronto, Ontario, Canada

Date of Submission21-Mar-2007
Date of Web Publication18-Apr-2007

Correspondence Address:
P Finch
330 Dupont Street, Toronto, Ontario M5R 1V9
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Source of Support: None, Conflict of Interest: None

PMID: 17647188


Purpose: the study was conducted in order to determine whether the level of motivation related to intrinsic (people-oriented) and extrinsic (external reward) value complexes in a class of massage therapy students changed during their professional education.
Methods: the research was a quasi-experimental within-subject design, in which survey data was collected from students on their first day in the massage therapy program and again towards the end of their final term. The data were collated and summarized, and the differences in motivation scores were assessed using Fisher's Least Significant Difference procedure.
Results: the results support the hypothesis that massage therapy students are motivated more strongly by intrinsic than extrinsic rewards both at the commencement of their studies and as they approach entry to practice. Also evident from the data is the fact that the students' motivation changed during their professional studies. This change involved a significant decrease in the level of intrinsic motivation and significant increase in the level of extrinsic motivation. Thus, although intrinsic motivation reduced while extrinsic motivation increased, the former remained the more powerful influence.
Conclusion: professional programs should consider the balance between intrinsic and extrinsic student motivation and attempt to control influences that might shift this such that the humanistic / altruistic mission of health care is undermined.

Keywords: Massage Therapy, Motivation, Education

How to cite this article:
Finch P. The Changing Motivation of Massage Therapy Students. Educ Health 2007;20:26

How to cite this URL:
Finch P. The Changing Motivation of Massage Therapy Students. Educ Health [serial online] 2007 [cited 2021 Feb 26];20:26. Available from:


The utilization of massage therapy and other complementary healthcare practices has been increasing globally (Goldbeck–Wood et al., 1996; Eisenberg et al., 1998). If these professions are to optimally meet certain health needs it is important that appropriately motivated individuals be admitted to professional schools. Previous work revealed that students entering professional education at a massage therapy school were more strongly motivated by intrinsic values related to helping and working with people than by the prospect of extrinsic rewards (Finch, 2004). These findings are similar to those relating to medical students (Kutner & Brogan, 1980; Silverston, 1988; Kahler & Soule, 1991; Hojat et al., 1998) and dental students (Vigild & Schwartz, 2001), the importance of which is highlighted by Guze (1995), who suggested that one way of meeting society’s needs is through medical/health care programs.

While admittance of intrinsically motivated students is important, it is at least equally important for curricula to harness and nurture this motivation in order to create competent clinicians with a humanistic approach to practice. Therefore, the present study was intended to determine whether the level of motivation related to intrinsic (people-oriented) and extrinsic (external reward) value complexes in a cohort of massage therapy students changed during the two years of their professional education.


Design The research was a quasi-experimental within-subject design, in which data were collected in relation to the motivations of a class of massage therapy students.

Procedures The study was approved by the operational review group of the host institution. On the first day of year one classes, 109 first term students of a four-term course were surveyed using a questionnaire based on the work of Rosenberg (1957) in which the students’ motivation in relation to two value complexes was assessed. Towards the end of their final term, the same cohort of students was again surveyed, yet it should be noted that the number of students in the class had dropped to 94. Both questionnaires were anonymous, the only difference between the instrument used in year one and at the end of year two was that in the latter case the students were asked to rate the importance of each of the four factors (further details of which can be found in the following section entitled Outcome Measures) in relation to entering practice, as opposed to entering professional education.

Of the surveyed class, 22% were male and 78% female, whereas the average age of the students was 29 years and 3 months (range 19-55). The ethnic make up of the group was predominantly Caucasian (79%) with the remainder being Asian (11%), Afro-American (1%), Latin/ Hispanic (7%) and Arabic (2%).

Outcome Measures The outcome measures were the questionnaire scores for intrinsic and extrinsic value complexes. As in Rosenberg’s original work, the intrinsic value complex was related to: (1) wishing to work with people and (2) the desire to help others. The extrinsic rewards complex on the other hand was related to: (1) the opportunity to earn a good income, and (2) the attainment of professional security/stability. Each of these four factors was rated on a seven-point interval scale with respect to its importance in influencing the students’ decision to enter massage therapy education, and subsequently, to enter practice.

The two value complexes indicated above were drawn from the original matrix that reflected a continuum of psychological distance between the different motivations associated with career choice. The coefficient of association related to the two items in the intrinsic value complex was 0.58, while that for the two items in the extrinsic complex was 0.59.

Data Analysis Data were collated and summarized, and the differences between the four groups of scores (Term 1: intrinsic and extrinsic complexes; Final term: intrinsic and extrinsic complexes) were compared using Fisher’s Least Significant Difference procedure (at a 95% confidence interval). Intra-term comparisons were based on paired data, while inter-term comparison was based on unpaired data due to the anonymous nature of the survey, and usual program attrition.


In term one a total of 84 surveys were returned, giving a response rate of 77.1% while towards the end of year two 72 surveys were returned, giving a response rate of 76.1%.

Table 1 below indicates the comparisons made, along with the values for each of the complexes. Each of the comparisons showed a statistically significant difference at a 95% confidence level.

The data indicate that at the point of entry to professional education (comparison #1) the students were significantly more motivated by intrinsic values than by the prospect of external rewards. Comparison # 2 indicates that this still holds true in relation to students’ motivations to enter practice after completing the program.

In the context of the first two comparisons, comparisons 3 and 4 indicate that although students were more strongly motivated by intrinsic than extrinsic values in both term 1 and their final term, the level of intrinsic motivation fell significantly. At the same time, the level of extrinsic motivation increased significantly towards the end of the program.

Table 1: Group Comparisons


In previous work (Finch, 2004) it was found that massage therapy students were influenced more strongly by intrinsic than extrinsic motivations at the commencement of their studies, and in this respect the motivation of the students involved in the current research was the same. It is also heartening to note that as the students approached the end of their educational program, altruistic motivation was still greater than motivation related to the prospect of extrinsic rewards. This bodes well because it is such individuals that will optimize the ability of the profession to fulfill its mission.

However, despite the positive results noted above, the fact that motivation changed in the way it did must give cause for concern. It is not known how far motivation must shift from intrinsic to extrinsic before practice patterns change, but it seems reasonable to suppose that if the balance shifts too far towards the extrinsic value complex then clinical decisions may be influenced more strongly by economic benefit than by the needs of the patient. This is contrary to a humanistic ethos of care in which clinical need is central, and hence such a development would clearly be undesirable.

At present, the reason for the change in motivation is not known, and further research is currently being undertaken in order to gain further insight into the matter.


The findings of this study indicate that students entering massage therapy school were motivated more strongly by intrinsic values related to the desire to help and work with people than by extrinsic rewards. This was the case at the point of entry to the program and also shortly before graduation and entry to practice. However, the level of intrinsic motivation decreased and the level of extrinsic motivation increased significantly over the course of their studies. It is not known if this shift is of practical significance, but professional programs might consider the benefit of guarding against influences that promote the shift towards extrinsic motivation, in order to support the humanistic / altruistic ethos of health care.


Methodologically, in inter-term comparisons, precision was reduced due to the unpaired nature of the data. However, this was off-set to a degree by the high response rate, and conceptually, that the focus of the work was on the entire class within the context of usual attrition rates. It is also important to note that the research was based on students enrolled at one massage therapy school in Canada, and although the results may be more broadly relevant, care must be taken in extrapolating the findings.


EISENBERG, D.M., DAVIS, R.B., ETTNER, S.L., APPEL, S., WILKEY, S., VAN ROMPAY, M., & KESSLER, R.C. (1998). Trends in Alternative Medicine Use in the United States, 1990-1997: Results of a Follow-Up National Survey. Journal of the American Medical Association, 280, 1569-1575.

FINCH, P. (2004). The Motivation of Massage Therapy Students to Enter Professional Education. Medical Teacher, 26(8), 729-731.

GOLDBECK-WOOD, S., DOROZYNSKI, A., LIE, L.G., YAMAUCHI, M., ZINN, C., JOSEFSON, D., & INGRAM, M. (1996). Complimentary Medicine is Booming Worldwide. British Medical Journal, 313, 131-133.

GUZE, P.A. (1995). Cultivating Curricular Reform. Academic Medicine, 70(11), 971-973.

HOJAT, M., BRIGHAM, T.P., GOTTHEIL, E., XU, G., GLASER, K., & VELOSKI, J.J. (1998). Medical Student’s Personal Values and Their Career Choices a Quarter Century Later. Psychological Reports, 83, 243-248.

KAHLER, J.A., & SOULE, D.J. (1991). A Survey of Medical Student’s Attitudes Toward Medical School and Factors Motivating Them to Become Physicians. South Dakota Journal of Medicine, 44(9), 269-272.

KUTNER, N.G., & BROGAN, D.R. (1980). The Decision to Enter Medicine: Motivations, Social Support, and Discouragements for Women. Psychology of Women Quarterly, 5 (2), 341-357.

ROSENBERG, M. (1957). Occupations and Values. Illinois: The Free Press.

SILVERSTON, S.E. (1988). Why Medical Students Become Medical Students. Wisconsin Medical Journal, 87, 23-25.

VIGILD, M., & SCHWARTZ, E. (2001). Characteristics and Study Motivation of Danish Dental Students in a Longitudinal Perspective. European Journal of Dental Education, 5, 127-133.


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